Incidence of hepatocellular carcinoma after HBsAg seroclearance in chronic hepatitis B patients: a need for surveillance.
J Hepatol
; 62(5): 1092-9, 2015 May.
Article
em En
| MEDLINE
| ID: mdl-25445399
ABSTRACT
BACKGROUND & AIMS:
Little is known about whether surveillance for hepatocellular carcinoma (HCC) is worthwhile in chronic hepatitis B virus (HBV)-infected patients who have achieved HBsAg seroclearance.METHODS:
A retrospective analysis of 829 patients (mean age 52.3 years; 575 males; 98 with cirrhosis) achieving HBsAg seroclearance was performed at a tertiary hospital in Korea between 1997 and 2012. We evaluated incidence rates of HCC, and validated CU-HCC score based on data at the time of HBsAg seroclearance.RESULTS:
During a follow-up of 3464 patient-years, 19 patients developed HCC (annual rate 0.55%). Liver cirrhosis (hazard ratio [HR] 10.80; 95% confidence interval [CI] 4.25-27.43), male gender (HR 8.96; 95% CI 1.17-68.80), and age ⩾50 years at the time of HBsAg seroclearance (HR 12.14; 95% CI 1.61-91.68) were independently associated with HCC. The estimated annual incidence of HCC was 2.85% and 0.29% in patients with and without cirrhosis, respectively. Among the non-cirrhotic patients, the annual rate of HCC was higher in the male patients than in the females (0.40% vs. 0%, respectively), and all the HCCs developed after age 50. The time-dependent area under the receiver operating characteristic curves for the CU-HCC score for 5 year and 10 year HCC prediction were 0.85 and 0.74, respectively.CONCLUSIONS:
HCC surveillance should be considered for cirrhotic patients and non-cirrhotic male patients over age 50, even after HBsAg seroclearance, especially those infected with HBV genotype C. HBsAg seroclearance at age ⩾50years was also an independent predictor for HCC.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Carcinoma Hepatocelular
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Hepatite B Crônica
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Antígenos E da Hepatite B
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Antígenos de Superfície da Hepatite B
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Cirrose Hepática
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Neoplasias Hepáticas
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article